Archive for September, 2017

Everybody’s Got a Story with Steven Stokes, M.D.

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Everybody’s Got a Story with Steven Stokes, M.D.

DOTHAN – Steven Stokes, M.D., grew up on a small farm in rural Alabama, which means he has lots of stories to tell about life in the country…with cows, the 4-H Club and football…all woven together with a closely knit family that seemed to get the better of him whether he liked it or not.

Dr. Stokes put pen to paper and wrote about his life on the farm, his time serving as a Marine in Vietnam, the misadventure of nearly missing his trip to the altar to wed his sweetheart, to the world’s worst medical school admission interview. His book, “Everybody’s Got a Story,” is available on Amazon, and all proceeds go to charity, which is something Dr. Stokes is also very serious about.

“I don’t really remember how I got so involved with Love In Action,” Dr. Stokes laughed. “I’ve been doing this for about five years now, and I remember it started with a phone call asking for help. That’s all it took for me.”

Although Love In Action Ministries is headquartered in Dothan, volunteers help residents in the Philippines, Myanmar, Haiti, and Pakistan. Dr. Stokes and three other physicians from the Houston County Medical Society signed on to help render aid every Thursday evening during the medical clinic hours.

“We’re all volunteers. We don’t get paid. I tell people that it’s a low return on investment. People get burned out when they volunteer. They think, ‘I just want to change the world. Well, you won’t. But occasionally you have some people that will turn their lives around. So then, you’re changing the world for those that you can help. You have to start somewhere,” Dr. Stokes said.

The largest population Love In Action aims to help are the homeless individuals that tend to get lost in the shuffle.

“The people we help are the homeless people who live under a bridge that barely have clothing and just don’t have access to the health care. We have a lot of migratory people here who will come through this area going south in the fall because winter’s coming, and in the spring they head back north. This is a high-transit area here, so we do what we can at Love In Action,” Dr. Stokes explained.

One saving grace for the charity has been the giving spirit of area nursing homes and physician practices and their willingness to donate supplies to further Love In Action’s mission, which extends beyond medical care. Area churches contribute to the charity for nondenominational services on the weekends and during the week the doors open for an opportunity to shower, change clothes and get a hot meal.

Dr. Stokes knows the community rather well. But, it was his interest in solving the community’s problems that called him to serve on the city commission for two terms and one term as chair of the school board.

“You never know what the long-term change is going to be. Change takes a while. I liked solving problems, and that’s how I got involved with government. Keeping our constituents happy wasn’t as easy,” Dr. Stokes laughed. “I’m glad doctors are serving more in their communities because they need to be involved in what happens around them.”

Gov. Kay Ivey recently reappointed Dr. Stokes to the Board of Trustees at the University of South Alabama School of Medicine, his alma mater, but he insists this will be his last term after serving for 24 years. “I’m getting too old, and I feel old,” he joked.

Dr. Stokes wrote in his book, “Many people pass through life and leave no tracks – nothing to bear witness to their passing. At best, they have a stone marker on their graves, or maybe a few kids who remember their names for one or two generations before oblivion.”

Dr. Stokes continues to make his mark on plenty of lives through his work with Love In Action in Dothan. If you would like to make a donation or to learn more, click here. However, if you’d like to find out what happened to his precious cow, Puddin’, you’ll have to buy his book. (All proceeds from book sales go to charity.)

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A HIPAA Contingency Plan: Yes, It’s Boring. Yes, You Must Do It.

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A HIPAA Contingency Plan: Yes, It’s Boring. Yes, You Must Do It.

When was the last time you reviewed your entity’s Contingency Plan? If it has been awhile, or never, you need to get to work. In light of recent natural disasters and ransomware attacks, the necessity of thorough and documented contingency planning, to include backup and disaster recovery, has become a focus for health care entities.

Pursuant to the Health Insurance Portability and Accountability Act (HIPAA) health care entities are required to account for the confidentiality, integrity and accessibility of their electronic protected health information (ePHI). They must consider potential incidents that may affect their information systems like fires, vandalism, malware attacks and tornados. Then they must document their strategy for operation during those events.

Contingency planning should begin with a review of the entity’s Risk Analysis. This document identifies what type of ePHI the entity accesses or maintains, where the data resides, and how the entity handles the data. Afterwards, the entity should begin the process of developing specific Administrative Safeguards.

A Data Backup Plan is essential, especially in instances of malware and natural disasters. Entities must put procedures in place to create and maintain exact copy backups of their data that they can readily retrieve. For example, if an entity is heavily damaged by a tornado or fire, they must be able to gain access to the data that they previously utilized within their entity. Without the benefit of timely system backups, the entity would not be able to recover up-to-date data which can be a serious liability when treatment decisions are being made about patients/clients without the benefit of their most current records.

The entity should ensure that there is an appropriate off-site backup of the entity’s ePHI and that the backup is being appropriately performed. These exact copy backups generally occur on a daily, weekly and monthly basis. The entity should maintain copies of these backups and should test the system periodically to ensure that the backup process is working in accordance with the required standards.

The ability to recover lost or stolen data can be critical. The entity should ensure that they have an effective Disaster Recovery Plan that complies with the National Institute of Standards and Technology (NIST) specifications.[1] The Disaster Recovery Plan should identify risks observed in the Risk Analysis and reflect a comprehensive plan to recover ePHI within specific time parameters, generally 24 to 48 hours. Additionally, careful consideration must be given to appropriate off-site locations that the entity could utilize if their primary location is no longer available. All workforce members should be informed of the plan and trained on their specific role.

An Emergency Mode Operations Plan documents the manner in which the entity will work throughout the course of the emergency. This relates to the critical business processes that must take place to protect ePHI during and following the emergency or disaster. Examples include determining the need for additional equipment or supplies, ensuring hardware and software compatibility to retrieve ePHI and if necessary, communicating changes to patients/clients.

Testing and Revision Procedures are required for the Data Backup, Disaster Recovery and Emergency Mode Operation Plans. These tests should occur within the timelines listed in the entities Risk Analysis and in all instances no less than annually. The testing process should be documented and evaluated to determine any need for revision.

Entities should perform an Application and Data Criticality Analysis to identify the information systems that are most important from a business operations perspective. This allows the entity to prioritize which databases need to be restored and in what order. For example, if a health care provider were the victim of a ransomware attack and they were attempting to recover the data, the Application and Data Criticality Analysis would identify the exact systems that are most crucial to their operations, allowing them to more easily prioritize the recovery process.

What does a compliance professional look for when auditing an entity for compliance with contingency planning? Entities should be able to produce the following:

  • A documented Contingency Plan which covers each of the specifications listed above, namely Data Backup Plan, Disaster Recovery Plan, Emergency Mode Operations Plan, Testing and Revision Procedures and Application and Data Criticality Analysis;
  • Documented roles and responsibilities of workforce members during disasters or emergencies;
  • Documentation that identifies the entities critical applications;
  • Documentation to demonstrate the plan is periodically reviewed and tested; and
  • Documentation that reflects whether amendments to the Contingency Plan or Risk Analysis were warranted and implemented, if applicable.

While contingency planning is important for appropriate business operations and HIPAA compliance, it is also critical to patient care. Patients count on health care providers to provide appropriate treatment and care during normal periods and during emergencies. If an emergency or disaster renders an entity without access to their ePHI with no plan to recover or otherwise gain access to the data, that creates unnecessary liability on behalf of the provider for treating the patient without access to their current records. Patient care should be paramount to the mission of all health care entities.

[1] Although only federal agencies are required to follow NIST standards, they represent industry standards for how health care entities should handle ePHI.

Samarria Dunson, J.D., CHC, CHPC is attorney/principal of Dunson Group, LLC, a health care compliance consulting and law firm in Montgomery, Alabama.  www.dunsongroup.com

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CVS Pharmacy, Others to Limit Prescriptions for Opioids

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CVS Pharmacy, Others to Limit Prescriptions for Opioids

Beginning in February 2018, CVS Pharmacy will limit the dose of opioid pain medication and restrict new prescriptions for acute pain to a 7-day supply, which adheres to the Centers for Disease Control and Prevention’s guidelines for prescribing opioids. This limit involves capping daily low-dosages and requires patients to receive versions of the medication that give pain-relief for a short period of time rather than a long duration. However, pharma companies seem to be following in the pharmacy’s footsteps as well.

According to the CVS plan, for a patient to receive an opioid prescription for longer than seven days, the patient would need to complete a pre-authorization for the medication — obtained after the pharmacy benefit manager consults with the prescribing doctor — and will have to pay for them out of pocket. The plan also includes in-store pharmacy training and awareness programs on opioid safety and addiction prevention, along with 750 in-store medical disposal units.

While the seven-day quantity limit on opioid prescriptions is intended for CVS Caremark’s PBM clients and applies only to prescriptions written for acute conditions, such as a minor surgery or dental procedure, CVS is not the first — and will not the be last — to place limitations on opioid prescriptions. Earlier this week during a meeting of President Trump’s opioid commission, the Pharmaceutical Research and Manufacturers of America announced support to limit the supply of opioids to seven days for acute pain management. PhRMA is a trade organization representing more than three dozen pharma companies, including AstraZeneca, Bayer, Allergan, Bristol-Myer Squibb, Eli Lilly, Johnson & Johnson, Merck, Pfizer, Teva, Novartis, GlaxoSmithKline, and Purdue Pharma.

In August, OptumRx announced the initial results of its Opioid Risk Management program, which is also reducing opioid use. The program places maximum fill limits on opioid therapy regardless of whether the patient is new to opioids or a chronic user. Results include:

  • 82 percent decrease in prescriptions above the CDC guideline recommended dose of 50 mg morphine equivalent dose (MED) per day for first-fill acute prescriptions;
  • 65 percent decrease in prescriptions for first-fill acute opioid treatment written above the maximum seven-day supply;
  • 68 percent decrease in prescriptions for current chronic opioid utilizers issues for >90 mg MED; and
  • 14 percent reduction in average dose across all opioid prescriptions.
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Gov. Ivey Proclaims September Rheumatic Disease Awareness Month

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Gov. Ivey Proclaims September Rheumatic Disease Awareness Month

If you suffer from the pain of arthritis, lupus or fibromyalgia, then you understand the scope of a rheumatic disease. Rheumatic diseases are the leading cause of disability in the United States and affect one-in-four Americans. By the year 2040, it’s estimated that more than 78 million American will be diagnosed with one of the many rheumatic diseases.

September 2017 is the second annual Rheumatic Disease Awareness Month, an initiative created by the American College of Rheumatology (ACR), to raise awareness about arthritis, lupus, gout, and more than 100 forms of rheumatic diseases. These diseases come with a price tag of more than $128 billion annually in medical expenditures. While research suggests the cause of rheumatic disease is a combination of genetic and environmental factors, the exact cause of these diseases is still unknown.

Learn more about rheumatic diseases and the Simple Tasks initiative sponsored by the American College of Rheumatology, which aims to raise awareness of the severe impact of rheumatic diseases and highlight the health care policy issues that affect patients’ ability to access high-quality care. You can get informed…and get help.

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STUDY: Patients Prescribed Opioids in the ER Less Likely to Use Them Long Term

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STUDY: Patients Prescribed Opioids in the ER Less Likely to Use Them Long Term

WASHINGTON – Compared to other medical settings, emergency patients who are prescribed opioids for the first time in the emergency department are less likely to become long-term users and more likely to be prescribed these powerful painkillers in accordance with The Centers for Disease Control and Prevention guidelines. A paper analyzing 5.2 million prescriptions for opioids is being published online today in Annals of Emergency Medicine (“Opioid Prescribing for Opioid-Naïve Patients in Emergency Department and Other Settings: Characteristics of Prescriptions and Association with Long-Term Use”).

“Our paper lays to rest the notion that emergency physicians are handing out opioids like candy,” said lead study author Molly Moore Jeffery, PhD., scientific director of the Mayo Clinic Division of Emergency Medicine Research in Rochester, Minn. “Close adherence to prescribing guidelines may help explain why the progression to long-term opioid use is so much lower in the ER. Most opioid prescriptions written in the emergency department are for a shorter duration, written for lower daily doses and less likely to be for long-acting formulations.”

In the emergency department, opioid prescriptions exceeding seven days were 84 to 91 percent (depending on insurance status) lower than in non-emergency settings. Prescriptions from the ER were 23 to 37 percent less likely to exceed 50 morphine milligram equivalents and 33 to 54 percent less likely to exceed 90-milligram equivalents (a high dose). Prescriptions from the ER were 86 to 92 percent less likely to be written for long-acting or extended-release formulations than those attributed to non-emergency settings.

Regardless of insurance status, patients receiving opioid prescriptions in the emergency department were less likely to progress to long-term opioid use. For patients seen in the ER, 1.1 percent with private insurance, 3.1 percent with Medicare (age 65 or older) and 6.2 percent with disabled Medicare progressed to long-term use. Put another way, patients with commercial insurance were 46 percent less likely to progress to long-term opioid use, Medicare patients age 65 and older were 56 percent less likely to progress to long-term opioid use and patients with disabled Medicare were 58 percent less likely to progress to long-term use if they received an opioid prescription in the emergency department.

“Over time, prescriptions written in the ER for high-dose opioids decreased between 2009 and 2011,” said Ms. Jeffery. “Less than 5 percent of opioid prescriptions from the ER exceeded seven days, which is much lower than the percentage in non-emergency settings. Further research should explore how we can replicate the success of opioid prescribing in emergency departments in other medical settings.”

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Coalition Pushes for CHIP Reauthorization

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Coalition Pushes for CHIP Reauthorization

 

 

DOWNLOAD A COPY OF THE JOINT LETTER

The Medical Association, the Alabama Chapter of the American Academy of Pediatrics, state lawmakers and a number of organizations advocating for children’s health care are petitioning the Alabama Congressional Delegation to support reauthorization of a bipartisan CHIP funding bill before the Sept. 30 deadline. In a letter to the Alabama Congressional Delegation outlining support for CHIP reauthorization, the coalition cited the great strides made possible through CHIP in ensuring children have access to the care they need. As well, any reductions in federal CHIP funding could cause problems for not only Alabama’s ALL Kids program but also children enrolled in Alabama Medicaid.

Below is the letter, and more signees are expected before the Sept. 30 deadline. Download a copy of the letter here.

We, the undersigned Alabama elected officials and organizations advocating for children and pregnant women in our state, write to urge your support of the Hatch-Wyden bill, Keeping Kids’ Insurance Dependable and Secure (KIDS) Act (S. 1827). This bipartisan legislation ensures stability for vulnerable children by extending funding for the Children’s Health Insurance Program (CHIP) for five years. The bill also provides additional protections for low-income children and increases flexibility for states.

As you know, federal funding for CHIP expires on September 30, 2017. Without certainty from Congress on CHIP funding, states will be forced to make drastic cuts to the program. This could mean slashing enrollment, reducing benefits, and imposing higher costs for families.

CHIP is a bipartisan success story. The program was created in 1997 and has been championed by lawmakers on both sides of the aisle since its very beginning. Together with Medicaid, CHIP has helped to reduce the numbers of uninsured children by a remarkable 68 percent. Now is the time for Congress to stabilize the CHIP funding stream and protect the gains in children’s health coverage that have resulted in more than 95 percent of all children in America being enrolled in some form of insurance coverage.

The program is designed around what children need. It offers benefits that are age-appropriate, including dental coverage and mental health and substance abuse services, which may not be covered by a family’s employer-sponsored insurance.

CHIP plans include networks of pediatricians, pediatric medical and surgical subspecialists, and children’s hospitals, which are especially critical for children with special health care needs.

Families deserve peace of mind knowing that they will be able to access the care and support services their children rely on to be healthy.

Currently in Alabama, 157,000 children are covered by CHIP, known as ALL Kids in our state. With state budgets already set for the coming year, states are counting on CHIP to continue in its current form. Changes to CHIP’s structure – including changes to the Maintenance of Effort or the enhanced CHIP matching rate – would cause significant disruption in children’s coverage and leave states with critical shortfalls in their budgets. Given CHIP’s track record of success, changes to CHIP that would cause harm to children must not be made. In Alabama, we would be forced to use funds originally appropriated for Alabama Medicaid to keep children covered on CHIP. So lack of continued funding at its current level would mean a double hit for Alabama!

Today, we stand united in urging you and your colleagues to work together to enact a five-year extension of CHIP funding.  Securing this critical source of coverage for children and pregnant women into the future is an important opportunity for meaningful, bipartisan action to honor CHIP’s 20 years of success.

Thank you for all you do for our state and the children of Alabama.

 

Sincerely,

Representative Steve Clouse, Chair, House Ways and Means General Fund Committee

Representative Anthony Daniels, House Minority Leader

Representative Nathaniel Ledbetter, House Majority Leader

Representative Mac McCutcheon, Speaker of the House

Representative April Weaver, Chair, House Health Committee

Senator Del Marsh, Senate President Pro Tempore

Senator Jim McClendon, Chair, Senate Health & Human Services Committee

Senator Greg Reed, Senate Majority Leader

Alabama Academy of Family Physicians

Alabama Arise

Alabama Chapter-American Academy of Pediatrics

Alabama Children First

Alabama Hospital Association

Children’s of Alabama

Medical Association of the State of Alabama

UAB Health System

University of South Alabama Health System

VOICES for Alabama’s Children

 

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Physicians Spend More Than Half of Work Day on Electronic Health Records

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Physicians Spend More Than Half of Work Day on Electronic Health Records

Primary-care physicians spend more than half of their workday on electronic health records during and after clinic hours, a University of Wisconsin School of Medicine and Public Health and American Medical Association study has found. The study, published online in the Annals of Family Medicine, shows physicians spent 5.9 hours of an 11.4 hour work day on electronic health records.

“While physician burnout happens for a number of reasons, spending a good deal of the work day and beyond on electronic health records is one of the things that leads to burnout,” said Dr. Brian Arndt, associate professor of family medicine and community health.

Arndt said 142 family-medicine physicians in the UW Health system were part of the study and all EHR interactions were tracked over a three-year period from 2013 to 2016 for both direct patient care and non-face-to-face activities.

He found that clinicians spent 4.5 hours during clinic each day on electronic health records. Another 1.4 hours before or after clinic were used for electronic health records documentation for a total of 5.9 hours each day.

That means that primary-care physicians spent nearly two hours on electronic health records per hour of direct patient care.

“When you factor in the non-electronic health records duties, it adds up to a workday of 11.4 hours, representing a significant intrusion on physicians’ personal and family lives,” said Arndt.

Order entry, billing and coding, and system security accounted for nearly half of the total electronic health records time (2.6 hours). Clerical duties like medication refills, interpretation of lab and imaging results, letters to patients, responding by e-mail to questions about medications and incoming and outgoing phone calls accounted for another 1.4 hours of every work day.

“It is imperative to find ways to reduce documentation burden on physicians,” said Arndt. “There are a couple of things to consider. Having clinical staff enter verbal or handwritten notes (based on a standardized checklist) could save time and allow physicians to focus more on the patient. In addition, documentation support by staff and additional training in documentation optimization should be available for interested physicians.”

Arndt said the electronic health records event logs used in the study can identify areas of electronic health records-related work that could be delegated to reduce workload, improve professional satisfaction and reduce burnout.

UW Health Chief Medical Information Officer and Senior Vice President Dr. Shannon Dean said the health system leadership supports and appreciates the work of Dr. Arndt and his colleagues in identifying areas of concern and supports reducing any undue burdens on physicians by proactively looking for ways to make the electronic health records system more efficient and distributing appropriate work amongst the clinical care team. Electronic health records systems do offer major benefits to patient care, so preserving their value is also a key goal.

Dean said initiatives include the recent deployment of single sign-on technology that addresses the time spent simply logging in and out of the system and the rollout of advanced voice-recognition software to allow providers to “dictate” directly into the system rather than type.

“UW Health acknowledges that the electronic health records and increased documentation requirements are contributing factors to physician burnout and has invested significant resources in education, optimization and support teams to ensure providers have ‘at the elbow’ support for doing their work,” said Dean. “Our support teams are currently meeting one-on-one with every provider to review their use of the electronic health records and provide them with tips and tricks to improve efficiency.”

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CMS Reveals New Medicare Card Design; Strengthens Fraud Protections

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CMS Reveals New Medicare Card Design; Strengthens Fraud Protections

The Centers for Medicare & Medicaid Services has redesigned its Medicare card to remove Social Security numbers and use a unique, randomly-assigned number in an effort to better protect users from identity theft and fraud.

CMS will begin mailing the new cards to people with Medicare benefits in April 2018 to meet the statutory deadline for replacing all existing Medicare cards by April 2019. People with Medicare will also be able to see the design of the new Medicare card in the 2018 Medicare & You Handbook. The handbooks are being mailed and will arrive throughout September.

“The goal of the initiative to remove Social Security numbers from Medicare cards is to help prevent fraud, combat identify theft, and safeguard taxpayer dollars,” said CMS Administrator Seema Verma. “We’re very excited to share the new design.”

CMS has assigned all people with Medicare benefits a new, unique Medicare number, which contains a combination of numbers and uppercase letters. People with Medicare will receive a new Medicare card in the mail, and will be instructed to safely and securely destroy their current Medicare card and keep their new Medicare number confidential. Issuance of the new number will not change benefits that people with Medicare receive.

Health care providers and people with Medicare will be able to use secure look-up tools that will allow quick access to the new Medicare numbers when needed. There will also be a 21-month transition period where doctors, health care providers, and suppliers will be able to use either their current SSN-based Medicare Number or their new, unique Medicare number, to ease the transition.

This initiative takes important steps towards protecting the identities of people with Medicare. CMS is also working with healthcare providers to answer their questions and ensure that they have the information they need to make a successful transition to the new Medicare number. For more information, please visit: www.cms.gov/newcard.

How can providers get ready for the changes?

  • Ask your billing and office staff if your system can accept the new 11-digit alphanumeric Medicare Beneficiary Identifier or
  • If your system cannot accept the new number, system changes should be made by April 2018
  • If providers use vendors to bill Medicare, ask them about their MBI practice management system changes and make sure they are ready for the change
  • Verify your patients’ addresses: If the address you have on file is different than the address you get in electronic eligibility transaction responses, ask your patients to contact Social Security and update their Medicare records. This may require coordination between your billing and office staff.

For more information go to https://www.cms.gov/Medicare/New-Medicare-Card/Providers/Providers.html

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AMASA Scholarships Help Students Achieve a Dream

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AMASA Scholarships Help Students Achieve a Dream

The AMASA Medical Student Scholarship Fund was established in 2012 to assist rising senior medical students. The scholarship is intended to aid students with financial responsibilities concomitant with interviews and travel in their senior year of medical school. This scholarship is made possible by the Alliance to the Medical Association of the State of Alabama through fundraising events and by general and memorial contributions. Multiple awards of at least $1,000 and up to $10,000 are presented at the annual meeting of the Medical Foundation of Alabama in April of each year.

This year, 19 students applied for the scholarships, and four were chosen to receive funds. It is with great pride that we awarded the following four candidates the 2017 AMASA Medical Student Scholarships, and we wish them all the best with the hope this monetary award helps them accomplish their goals:

Elijah Rogers, Alabama College of Osteopathic Medicine

Elijah, a native of Dothan, has led an indirect path toward the field of medicine, but it was always his lifelong goal. After graduating from Auburn University, he felt medical school would put too much stress on his relationships and would not be possible, so he worked as an environmental scientist for the State of Alabama. He married right after graduating from Auburn, and he became restless and unfulfilled in his career goals a few years after graduating. So, after soul searching and talking to his wife, he decided to quit his job and go to medical school.

Elijah is currently at the Alabama College of Osteopathic Medicine, and he and his wife have two children. Though hectic, he felt more balanced in medicine and has excelled. He has a stellar academic record and though he spends most of his time outside of school studying and raising his children, he still carves out time to volunteer doing health screenings in his community.His friend wrote to AMASA and said of him, “Elijah is driven by what is right, not blind ambition.” He hopes to pursue a career in general surgery, and we are honored to help him reach his goal: “To provide for my family; to refine my natural abilities and knowledge in order to apply them to challenging problems, and to serve my community with compassion and bless others as I have been blessed.”

His friend wrote to AMASA and said of him, “Elijah is driven by what is right, not blind ambition.” He hopes to pursue a career in general surgery, and we are honored to help him reach his goal: “To provide for my family; to refine my natural abilities and knowledge in order to apply them to challenging problems, and to serve my community with compassion and bless others as I have been blessed.”

Gerard Holder, Alabama College of Osteopathic Medicine

Gerard is a native of Huntsville, and is currently at the Alabama College of Osteopathic Medicine. Though he is early in his training and career, Gerard has already contributed to a great deal of medical research and has an impressive number of publications. He continues to serve his community by participating in Feeding the Gulf Coast as a nutrition assistant, helping educate low-income and at-risk families on healthy eating habits and proper nutrition. He also takes time out of his studies to mentor other students at ACOM and helps them on their paths to becoming physicians.

Gerard is a first-generation college graduate, and he has risen out of a high-risk community. He aspires to train in Medicine or Medicine/Pediatrics and then specialize in Hematology/Oncology. He hopes he can make a large positive contribution to cancer research in his career as a physician.

Amber Dixon, University of Alabama School of Medicine

Amber is an extremely accomplished medical student at The University of Alabama School of Medicine. In addition to excelling in academics and patient care throughout her medical school career, Amber served as the vice president of the Student National Medical Association and secretary of the Global Health Interest Group. She is also coordinator Women in Medicine, where she connects female medical students with female physicians in the area for mentoring, networking and education.Amber is a first-generation college

Amber is a first-generation college student, and writes that most of her friends from her hometown of Kinsey did not go to college. She uses her life experience to encourage students to stay in school and reach their goals. She plans to train in Psychiatry and practice in an underserved area to give her future patients access to care that might be a struggle for them.

Luke Iannuzzi, University of Alabama School of Medicine

Luke is a native of Auburn and attended the University of Kentucky for undergrad. He is married and currently a student at The University of Alabama School of Medicine where he has excelled in research and volunteerism in the field of Pediatrics. He is a member of the Learning Environment Council and the Psychiatry Chair of the Service Learning Committee, in which he helps organize community service projects for medical students. In addition to research and publications, Luke serves as the Vice Chair of the Black Warrior Perinatal Community Action Team, which helped develop and implement strategies to improve perinatal health in Tuscaloosa and surrounding counties. Luke strives to see the entire picture of the patient and treat the whole person, therefore he would like to pursue a career in Family Medicine. He wants to continually strive to do the absolute best for his patients, and we at AMASA have confidence he will do just that.

The Scholarship award process was facilitated by Committee Chair Marie Schneider, Madison County, and Committee members Donna Shergy, Madison County; Karen Alford, Mobile County; and Trudie Sierafi, Montgomery.

Donations to the Scholarship Program can be sent to AMASA Treasurer Mary Beth Lloyd, 5949 Crestwood Circle, Birmingham, AL 35212. In the fall, there will be a plan in place for donations to be made directly to the AMASA Scholarship Fund from retirement accounts.

Article contributed by the Alliance to the Medical Association of the State of Alabama

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U.S. Senate Announces 5-Year CHIP Funding Program

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U.S. Senate Announces 5-Year CHIP Funding Program

The U.S. Senate Finance Committee reached an estimated $8 billion bipartisan agreement that renews funding for the Children’s Health Insurance Program for five years and phases out the 23 percent Obamacare funding bump. States would have to maintain eligibility through 2019, and after that there would be no so-called maintenance of effort for children of parents with incomes more than 300 percent of the federal poverty level.

While the deal does not include details of how the Congress would pay for the funding extension, the proposed legislation would maintain Obamacare’s 23 percent increase in the federal matching rate to states for 2018 and 2019 and begin to ratchet it down in 2020, according to GOP and Democratic aides. The bump is set at 11.5 percent in 2020 and would be totally eliminated starting in 2021. Amendments to the proposed legislation are expected.

“The Medical Association began working with Alabama’s Congressional Delegation in January when we traveled to Washington, D.C., for the Government Relations Conference,” said Executive Director Mark Jackson. “We wanted to express to them the importance that CHIP funding be renewed and the impact the program has on our residents. We are pleased to see that there is a bi-partisan proposal in the Senate that will keep CHIP funding in place.”

CHIP is authorized through 2019, but funding runs out at the end of September. CHIP covers families with income levels between 138 percent and 405 percent of the federal poverty level. States determine the eligibility levels within those parameters, and the ACA requires that states maintain eligibility levels that were in place as of March 23, 2010. States that reduce eligibility lose federal Medicaid funding. Eligibility levels are capped between 200 percent and 300 percent of poverty in 30 states, and in 19 states eligibility levels are higher than 300 percent of poverty, although those states don’t receive the higher match rate for enrollees above the 300 percent threshold, according to American Action Forum. The Finance deal would let states drop eligibility levels to 300 percent of poverty after 2019.

More than 97 percent of CHIP enrollees have family income of 250 percent of poverty, according to the American Action Forum analysis.

The American Academy of Family Physicians and more than 130 other organizations issued a statement on Sept. 6 calling on legislators to save the CHIP from chaos and families from confusion by extending the program’s funding for five years before it expires on Sept. 30.

“CHIP has a proven track record of providing high-quality, cost-effective coverage for low-income children and pregnant women in working families,” the statement said. “CHIP was a smart, bipartisan solution to a real problem facing American children and families when it was adopted in 1997, and its importance and impact in securing a healthy future for children in low-income families has only increased. As Congress continues to work on larger health system reforms, a primary goal should be to improve health coverage for children, but at a minimum, no child should be left worse off. We urge our nation’s leaders to work together to enact a five-year extension of CHIP funding as an important opportunity for meaningful, bipartisan action.”

Nearly 9 million children whose families could not otherwise afford health insurance have access to health care because of CHIP. The program also enables pregnant women in 19 states to obtain the health care they need to have healthy pregnancies and give birth to healthy infants. Many families covered by the program have incomes too high to qualify for Medicaid.

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